PARENTS

Safe Sleep For Your Baby: Your Questions About Cot Death Answered

14/08/2014 16:50 | Updated 22 May 2015

Safer sleep for your baby: your questions about SIDS answered

Sadly Sudden Infant Death Syndrome (SIDS) is back in the news. We've consulted the experts at charity Lullaby Trust, (formerly known as FSID - the Foundation for the Study of Infant Deaths), for their advice about keeping your baby as safe as possible whilst he or she sleeps.

It can be tempting not to think about the worst that could happen to our precious babies but, armed with the right evidence-based knowledge, you can reduce the risks of this happening to you.

So what is SIDS?

The Lullaby Trust defines SIDS as the sudden and unexplained death of a baby for no obvious reason. SIDS used to be commonly known as cot death, because most cases occur when a baby is sleeping, and is still sometimes referred to as this.

How common is it?

Sadly over 300 babies die of SIDS each year in the UK and it's one of the main causes of death among babies under 12 months. However, to keep things in perspective, it's worth remembering this is a rare phenomenon and rates have fallen significantly over the last 20 years since campaigns to educate parents on safer sleeping for their babies were first introduced.

What's the cause?

Unfortunately experts still don't know the answer to this, although research has uncovered a number of risk factors over the years which have then shaped the advice on safe sleeping that every new parent should take on board.

So what can I do to prevent it happening to my baby?

Jenny Ward, Head of Support and Development at the Lullaby Trust advises: "There is no advice which guarantees the prevention of Sudden Infant Death Syndrome (SIDS), but parents can take practical steps to substantially reduce their baby's risk by following the safer sleep recommendations."

Key recommendations and questions:

Put your baby down to sleep on her back not her front

In the 70s and 80s parents were advised to lie babies down to sleep on their fronts but subsequent research has shown that this increases the risk and newborns should sleep on their backs.

It's easy for cynics, among the grandparents perhaps, to say that 'we all put you to bed on your front and you survived' but since the introduction of recommendations that babies should sleep in their backs, rates of SIDS have fallen considerably.

What about when my baby starts rolling over and I can't keep him on his back any more?

SIDS is more common in babies under six months, with a peak at two to three months. By the time most are able to roll into a front sleeping position, the risk will be lower anyway.

Continue to put your baby on his back when he is placed in the cot or crib at night or for naps. If you happen to see he has rolled onto his stomach, move him back but don't feel you have to stay awake all night checking for this. Once he can roll from front to back, and back to front, it's fine to leave him to find his own, most comfortable position.

Have your newborn sleep beside you in your room but not in your bed for her first six months

Many parents like to co-sleep or bed share with their baby but the safest place for him or her to sleep is in your room in a separate cot (or crib). Recent news coverage of this provoked much debate, with some parents stating a strong preference for bedsharing and how it makes breastfeeding easier.

It's a very personal decision but it is especially important not to bedshare if you or your partner have been drinking or smoking or if your baby was premature or low birth weight.

Whilst it's all too easy, as an exhausted new parent, to doze off on the sofa or armchair with your baby snuggling up on you, this can also be a risk - a sixth of babies who died in England and Wales did so when sleeping in this way.

Don't smoke in pregnancy or after the birth - dads too!

There is a clear association between smoking in pregnancy and SIDS, shown from a large number of worldwide studies. The risk is also increased if either or both parents smoke and then bedshare, even if they are not smoking in bed. The advice on this is clear and applies for other medical reasons too: don't smoke in pregnancy or after the birth (fathers too!) and keep your baby out of smoky atmospheres.

Avoid overheating and don't cover a baby's head in bed

Keep room temperature moderate whenever possible - 16 to 20 degrees is ideal and adjust bedding accordingly. Blankets and other bedding should be lightweight or you can use a baby sleep bag in an appropriate tog rating (see below).

Never put anything on your baby's head when she's in her cot/ crib/ moses basket - the head is an important source of heat loss and a high proportion of baby's who have died of SIDS had their heads covered - not necessarily with a hat or hood. When you come into the house from a cold day, if your baby has nodded off en route, remove hats and adjust bedding or clothing if it's warm inside.

Keep the cot as clear as possible

Avoid using duvets, pillows and thick quilts for under 12-month-olds. Blankets and sheets can end up kicked over an infant's head - if you prefer to use them instead of sleep bags, tuck your baby into the 'feet to foot position' with the blankets tucked into the bottom of the mattress. Many parents now prefer baby sleep bags though - as long as these are in the right size (with the neck hole smaller than the baby's head) and are fastened properly, they can't end up over a baby's head. due to their design.

Use a clean, firm mattress in the cot/ crib

Your baby's cot or crib should have a clean, firm and flat mattress. This will probably feel harder than most grown ups' beds - don't worry she'll still be comfortable. Using a breathable, waterproof mattress cover will help on the cleanliness front.

Breastfeed your baby

Breastfeeding has been shown to reduce the incidence of SIDS, so if possible (and we know it isn't always easy) do breastfeed.

Consider using a soother/ dummy

Studies have uncovered that dummies are beneficial in helping prevent SIDS. It's best to wait to introduce one until breastfeeding is established - usually during the first month and wise to stop using it when your baby is between six and 12 months of age to prevent damage to teeth. If the dummy falls out whilst your little one is asleep, there's no need to replace it and if it's refused, don't force your baby to take it.

What about cot bumpers?

These are no longer recommended in the US by the American Association of Paediatrics due to safety concerns. There is no such official advice here at the time of writing, but if you want to make your baby's cot as safe as possible, avoid them and save your money! They don't really serve a useful purpose for newborns as they can't move around the cot anyway and they need to be removed as soon as a little one can stand up, so they can't get a leg up on them and climb out of their cot.

Reduce the risk of cot death – a summary from The Lullaby Trust

• Place your baby on their back to sleep (and not on the front or side)

• Cut smoking in pregnancy - dads too! And don't let anyone smoke in the same

room as your baby

• The safest place for your baby to sleep is in a crib or cot in a room with you for the

first six months

• Never sleep with your baby on a sofa or armchair

• Do not let your baby get too hot, and keep your baby's head uncovered

Consult the Lullaby Trust website for more information and advice about SIDS.

Liat Hughes Joshi is author of What to Buy for Your Baby.

PRODUCTS FOR SAFER SLEEPING

No product can prevent SIDS and parents should be careful of those making claims they do so. That said, there are a few that might assist you in keeping to the safe sleeping guidance...

Baby sleep bag1. Baby sleep bag

Why might this help?

Whilst conventional bedding can end up kicked over a baby's head, a sleeping bag in the correct size (with the neck hole smaller than your baby's head), can't. It might also help keep her on her back as they're harder to roll and move about in.

But watch out for:

Baby sleep bags shouldn't have hoods - always keep your baby's head uncovered during sleeping times. Ensure the warmth of the bag (usually shown as a tog rating) is appropriate for the room temperature.

Shown here: Grobag Baby Sleep Bag, from £25.99, www.gro.co.uk

A dummy2. A dummy

Why might this help?

Soothers/ dummies have been shown to reduce the risk of SIDS, although the reason is still unclear.

But watch out for: Wait until breastfeeding is established before introducing a dummy - usually within the first month.

Shown here: Mam Original Soother, £4.90, www.mambaby.com

Bedside crib

3. Bedside crib

Why might this help?

Bedsharing isn't recommended and is one of the biggest risk factors, so you should put your baby to sleep in a separate cot or crib.

Bedside cribs from brands such as Bednest, BabyBay and Troll, have a side that can be dropped away so that your baby is still in a separate space but can be accessed more easily for night feeds or just if you want to stick an arm out to reassure them in the night!

But watch out for: Make sure the crib or cot is flush to your own mattress, without a gap.

Shown here: NCT Bednest bedside crib, £299 to buy, also available to rent, www.nctshop.co.uk

 Waterproof mattress cover4. Waterproof mattress cover

Why might this help?

Not a major factor but this should ensure you can keep your little one's mattress clean and hygienic - practical for other reasons too, in case of nappy leaks and sickness episodes in the night.

But watch out for: Choose one that's breathable rather than plasticky and sticky.

Shown here: John Lewis Baby Towelling Mattress Protector, £20, www.johnlewis.com

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